METHODS: In a prospective, double-blinded, single-center study, 42 subjects with chronic urticaria were randomized to high (4,000 IU/d) or low (600 IU/d) vitamin D3 supplementation for 12 weeks.
All subjects were provided with a standardized triple-drug therapy (

cetirizine,

ranitidine, and

montelukast)

and a written action plan. Data on USS scores, medication use, blood for 25-hydroxyvitamin D, and safety measurements were collected.

RESULTS: Triple-drug therapy decreased total USS scores by 33% in the first week. There was a further significant decrease (40%) in total USS scores in the high, but not low, vitamin D3 treatment group by week 12. Compared with low treatment, the high treatment group demonstrated a trend (P = .052) toward lower total USS scores at week 12, which was driven by significant decreases in body distribution and number of days with hives. Beneficial trends for sleep quality and pruritus scores were observed with high vitamin D3. Serum 25-hydroxyvitamin D levels increased with high vitamin D3 supplementation, but there was no correlation between 25-hydroxyvitamin D levels and USS scores. There was no difference in allergy medication use between groups. No adverse events occurred.

CONCLUSION: Add-on therapy with high-dose vitamin D3 (4,000 IU/d) could be considered a safe and potentially beneficial immunomodulator in patients with chronic urticaria.

Vitamin D will probably boost urticaria therapy - Aug 2014

Chronic urticaria is a common skin condition whereby the etiology remains largely idiopathic and the mainstay therapy is symptomatic control with antihistamines. There have been a limited number of small studies suggesting a potential role for vitamin D in chronic urticaria, and this this editorial review will discuss the current supporting evidence. Associations for decreased serum vitamin 25 hydroxyvitamin D levels in subjects with chronic urticaria have been reported. In addition to observational reports, there has been a randomized, prospective, blinded trial demonstrating symptom improvement when high vitamin D3 supplementation was utilized as an add-on therapy for urticarial management. More research is needed to address mechanisms of action and to investigate vitamin D supplementation in larger and longer duration human trials.

Vitamin D plays an important role in the immune system; decreased serum vitamin D concentrations have been linked to dysregulated immune function. Low vitamin D status is probably associated with chronic spontaneous urticaria (CSU). We evaluated the prevalence of low vitamin D status, and the clinical response and quality of life following vitamin D supplementation, in a prospective case-control study with 60 CSU patients and 40 healthy individuals. Serum 25-hydroxy vitamin D (25(OH)D) concentrations were measured at baseline and after 6 weeks. For patients with 25(OH)D concentrations < 30 ng/ml, treatment included 20,000 IU/day of ergocalciferol (vitamin D2) and non-sedative antihistamine drugs for 6 weeks. Urticaria symptom severity and quality of life were assessed based on the Urticaria Activity Score over 7 days (UAS7) and the Dermatology Life Quality Index (DLQI). Of the 100 participants, 73% were female; the mean age was 39 ± 16 years. Vitamin D deficiency (measured as 25(OH)D < 20 ng/ml) was significantly higher in the CSU group than the control group. The median 25(OH)D concentration for the CSU group, 15 (7 - 52) ng/ml was significantly lower than for control group, 30 (25 - 46) ng/ml. Overall, 83% (50/60) of CSU patients (25(OH)D < 30 ng/ml) were treated with ergocalciferol (vitamin D2) supplementation; after 6 weeks, these patients showed significant improvements in UAS7 and DLQI scores compared with the non-vitamin D supplement group. This study revealed a significant association of lower serum 25(OH)D concentrations with CSU. Vitamin D supplements might improve symptoms and quality of life in CSU patients.

Chronic urticaria is the most common skin diseases, characterized by chronic cutaneous lesions which severely debilitates patients in several aspects of their everyday life. Vitamin D is known to exert several actions in the immune system and to influence function and differentiation of mast cells, central role players in the pathogenesis of chronic idiopathic urticaria. This study was performed to evaluate the relationship between vitamin D levels and susceptibility to chronic idiopathic urticaria. One hundred and fourteen patients with chronic idiopathic urticaria were recruited in this study along with one hundred and eighty seven sex-matched and age-matched healthy volunteers as the control group. For each patient, urticaria activity score was calculated and autologous serum skin test was done. Vitamin D metabolic statue was measured in serum as 25 hydroxyvitamin D using enzyme immunoassay method. Patients with chronic idiopathic urticaria significantly showed lower levels of vitamin D. Vitamin D deficiency was significantly associated with increased susceptibility to chronic idiopathic urticaria. There was a significant positive correlation between vitamin D levels and urticaria activity score. This study showed that patients with chronic idiopathic urticaria had reduced levels of vitamin D, while vitamin D deficiency could increase susceptibility to chronic idiopathic urticaria.

Clipped from resultsPatients with CIU and particularly with true CIU significantly showed lower levels of 25 (OH)D in
comparison with the control group (p=0.005) (Figure 1). However, considering AICU patients separately,
there was no significant differences in vitamin D levels between them and the control group (p=0.11). Vitamin
D deficiency was significantly associated with increased susceptibility to CIU (p=0.001). Individuals
with vitamin D deficiency showed a 2.4-fold (95%CI: 1.4-4) risk of having CIU. In addition, vitamin D
deficiency significantly increased susceptibility to true CIU (p=0.001, OR=2.7, 95%CI: 1.4-5.1). However,
slight significant difference was detected between the controls and the AICU patients regarding vitamin D
deficiency (p=0.048, OR=2.04, 95%CI: 0.99-4.2)(Table 2).

BACKGROUND:
Vitamin D plays a key role in the immune responses generated by lymphocytes and antigen-presenting cells. Decreased vitamin 25-hydroxyvitamin D (25(OH)D) levels has been implicated in several allergic disorders and association between 25(OH)D levels and chronic urticaria (CU) symptom scores has been in a few studies. This study was performed to assess the effects of vitamin D supplementation on the symptoms and quality of life scores in chronic spontaneous urticaria and to vitamin D levels in CSU patients in comparison with controls.

PATIENTS AND METHODS:
Fifty-eight CSU patients and forty-five controls were included in the study. The patients were divided into two groups according to severity of the disease; as mild/moderate and severe urticaria. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured in serum of CSU patients and compared with the control groups. In patients with 25(OH)D concentrations lower than 30 µg/L, 300.000 IU/month of vitamin D3 supplementation was added to standard therapy. The clinical improvement was evaluated after 3 months with urticaria activity score (UAS4) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL).

RESULTS:
Serum 25(OH)D concentration was significantly lower in CSU group compared to healthy subjects (p<0.001). The prevalance of vitamin D deficiency (< 20 (µg/L) and insufficiency (< 30 µg/L) was significantly higher in CSU patients than control groups. In addition, 25(OH)D concentrations were significantly lower in both mild- moderate and severe CSU patients than those of the controls (P=0.011 and p<0.001, respectively). Ninety eight percent of patients (25(OH)D < 30 µg/L) were treated with vitamin D3 (300.000 IU/month-1) supplementation, and after 12 weeks, these patients showed significant improvements in UAS4 and CU-Q2oL scores.

CONCLUSION:
This study support the contributing and beneficial effects of vitamin D in the treatment of chronic urticaria. Replacement of vitamin D may provide improvement in both the severity of symptoms and quality of life scores in these patients.

See also web

Vitamin D Blog: Help for Hives? MedPageToday
‘’ In the first week, both groups saw a 33% decrease in symptoms. But only the high-dose vitamin D group saw a further reduction in symptoms (40%) by the end of the study.’’
High dose = 4,000 IU vitamin D daily

UNMC study: Vitamin D provides relief for those with chronic hives Press Release
“It was not a cure, but it showed benefit when added to anti-allergy medications. Patients taking the higher dose had less severe hives — they didn’t have as many hives and had a decrease in the number of days a week they had hives.
In the study, patients had suffered from five to 20 years with severe hives. Some had been on therapy and others none.